RSS-Feed abonnieren
Bitte kopieren Sie die angezeigte URL und fügen sie dann in Ihren RSS-Reader ein.
https://www.thieme-connect.de/rss/thieme/de/10.1055-s-00000075.xml
PDF herunterladen
Semin Respir Crit Care Med 2005; 26(5): 490-501
DOI: 10.1055/s-2005-922032
DOI: 10.1055/s-2005-922032
Lymphoproliferative Lung Disorders
Weitere Informationen
Publikationsverlauf
Publikationsdatum:
02. November 2005 (online)
ABSTRACT
Although the lung is frequently involved by disseminated lymphoma, isolated pulmonary lymphoma is rare, accounting for less than 1% of all extranodal localized disease. Three broad categories of lymphoma of the lung require recognition: in rare instances, large B cell type lymphoma can present primarily in the lung; a second variant is by T cell lymphoma presenting as an angiocentric process. However, the most common histologic subtype is represented by low-grade mucosa-associated lymphoid tissue (MALT) lymphoma, often in the past considered as a pseudotumor because of its long indolent natural history. Common presenting features include cough, dyspnea, pain, fever, recurrent infections, hemoptysis, or an asymptomatic finding on routine chest radiograph. Precise pathological diagnosis and molecular characterization are required in all cases, following World Health Organization classification criteria. Radiological features include pulmonary consolidation, solid pulmonary opacities, hilar adenopathy, or pleural effusion. Principles of treatment vary with the different histology.
KEYWORDS
MALT - lymphoma - primary pulmonary
REFERENCES
- 1 Freeman C, Berg J W, Cutler S J. Occurrence and prognosis of extranodal lymphomas. Cancer. 1972; 29 252-260
- 2 Harris N L, Jaffe E S, Diebold J et al.. The World Health Organization classification of neoplastic diseases of the haematopoietic and lymphoid tissues: report of the Clinical Advisory Committee Meeting, Airlie House, Virginia, November 1997. Histopathology. 2000; 36 69-86
- 3 Sutcliffe S B, Gospodarowicz M K.
Clinical features and management of localized extranodal lymphomas . In: Keating A, Armitage J, Burnet A, Newland A Haematology Oncology. Vol 2. Cambridge; Cambridge University Press 1992: 189-223MissingFormLabel - 4 Kurtin P J, Myers J L, Adlakha H et al.. Pathologic and clinical features of primary pulmonary extranodal marginal zone B-cell lymphoma of MALT type. Am J Surg Pathol. 2001; 25 997-1008
- 5 Lister T A, Crowther D, Sutcliffe S B et al.. Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin's disease: Cotswold Meeting. J Clin Oncol. 1989; 7 1630-1636
- 6 Hansen L A, Prakash U BS, Colby T V. Pulmonary lymphoma in Sjögren's syndrome. Mayo Clin Proc. 1989; 64 920-931
- 7 Lim J K, Lacy M Q, Kurtin P J et al.. Pulmonary marginal zone lymphoma of MALT type as a cause of localised pulmonary amyloidosis. J Clin Pathol. 2001; 54 642-646
- 8 Montalban C, Obeso G, Gallego A et al.. Peripheral T-cell lymphoma: a clinicopathological study of 41 cases and evaluation of the prognostic significance of the updated Kiel classification. Histopathology. 1993; 22 303-310
- 9 Cordier J, Chailleux E, Lauque D et al.. Primary pulmonary lymphomas: a clinical study of 70 cases in nonimmunocompromised patients. Chest. 1993; 103 201-208
- 10 Poletti V, Romagna M, Gasponi A, Baruzzi G, Allen K A. Bronchoalveolar lavage in the diagnosis of low-grade, MALT type, B-cell lymphoma in the lung. Monaldi Arch Chest Dis. 1995; 50 191-194
- 11 Zaer F S, Braylan R C, Zander D S, Iturraspe J A, Almasri N M. Multiparametric flow cytometry in the diagnosis and characterization of low-grade pulmonary mucosa-associated lymphoid tissue lymphomas. Mod Pathol. 1998; 11 525-532
- 12 Achille A, Scarpa A, Montresor M et al.. Routine application of polymerase chain reaction in the diagnosis of monoclonality of B-cell lymphoid proliferations. Diagn Mol Pathol. 1995; 4 14-24
- 13 van Dongen J J, Langerak A W, Bruggemann M et al.. Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: report of the BIOMED-2 Concerted Action BMH4-CT98-3936. Leukemia. 2003; 17 2257-2317
- 14 Treasure J, Lane A, Jones D B, Wright D H. CD43 expression in B cell lymphoma. J Clin Pathol. 1992; 45 1018-1022
- 15 Begueret H, Vergier B, Parrens M et al.. Primary lung small B-cell lymphoma versus lymphoid hyperplasia: evaluation of diagnostic criteria in 26 cases. Am J Surg Pathol. 2002; 26 76-81
- 16 Raderer M, Vorbrck F, Formanck M et al.. Importance of extensive staging in patients with mucosa associated lymphoid tissue (MALT)-type lymphoma. Br J Cancer. 2000; 83 454-457
- 17 Thieblemont C, Bastion Y, Berger F et al.. Mucosa-associated lymphoid tissue gastrointestinal and nongastrointestinal lymphoma behaviour: analysis of 108 patients. J Clin Oncol. 1997; 15 1624-1630
- 18 Zinzani P L, Magagnoli M, Galieni P et al.. Nongastrointestinal low-grade mucosa-associated lymphoid tissue lymphoma: analysis of 75 patients. J Clin Oncol. 1999; 17 1254-1258
- 19 Cavalli F, Isaacson P G, Gascoyne R D, Zucca E. MALT Lymphomas. Hematology (Am Soc Hematol Educ Program). 2001; 241-258
- 20 Thieblemont C, Berger F, Dumontet C et al.. Mucosa-associated lymphoid tissue lymphoma is a disseminated disease in one third of 158 patients analyzed. Blood. 2000; 95 802-806
- 21 Yonezumi M, Suzuki R, Suzuki H et al.. Detection of AP12-MALT1 chimaeric gene in extranodal and nodal marginal zone B-cell lymphoma by reverse transcription polymerase chain reaction (PCR) and genomic long and accurate PCR analyses. Br J Haematol. 2001; 115 588-594
- 22 Addis B J, Hyjek E, Isaacson P G. Primary pulmonary lymphoma: a reappraisal of its histogenesis and its relationship to pseudolymphoma and lymphoid interstitial pneumonia. Histopathology. 1988; 13 1-17
- 23 Isaacson P G, Du M Q. MALT lymphoma: from morphology to molecules. Nat Rev Cancer. 2004; 4 644-653
- 24 Wotherspoon A C, Doglioni C, Diss T C et al.. Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori. Lancet. 1993; 342 575-577
- 25 Ambrosetti A, Zanotti R, Pattaro C et al.. Most cases of primary salivary mucosa-associated lymphoid tissue lymphoma are associated either with Sjögren syndrome or hepatitis C virus infection. Br J Haematol. 2004; 126 43-49
- 26 Garbe C, Stein H, Dienemann D, Orfanos C E. Borrelia burgdorferi-associated cutaneous B cell lymphoma: clinical and immunohistologic characterization of four cases. J Am Acad Dermatol. 1991; 24 584-590
- 27 Kurosu K, Yumoto N, Furukawa M, Kuriyama T, Mikata A. Low-grade pulmonary mucosa-associated lymphoid tissue lymphoma with or without intraclonal variation. Am J Respir Crit Care Med. 1998; 158(5 Pt 1) 1613-1619
- 28 Reichenberger F, Wyser C, Gonon M, Cathomas G, Tamm M. Pulmonary mucosa-associated lymphoid tissue lymphoma in a patient with common variable immunodeficiency syndrome. Respiration. 2001; 68 109-112
- 29 Mhawech P, Krishnan B, Shahab I. Primary pulmonary mucosa-associated lymphoid tissue lymphoma with associated fungal ball in a patient with human immunodeficiency virus infection. Arch Pathol Lab Med. 2000; 124 1506-1509
- 30 Nicholson A G, Wotherspoon A C, Jones A L, Sheppard M N, Isaacson P G, Corrin B. Pulmonary B-cell non-Hodgkin's lymphoma associated with autoimmune disorders: a clinicopathological review of six cases. Eur Respir J. 1996; 9 2022-2025
- 31 Gaur S, Trayner E, Aish L, Weinstein R. Bronchus-associated lymphoid tissue lymphoma arising in a patient with bronchiectasis and chronic Mycobacterium avium infection. Am J Hematol. 2004; 77 22-25
- 32 Ott G, Katzenberger T, Greiner A et al.. The t(11;18)(q21;q21) chromosome translocation is a frequent and specific aberration in low-grade but not high-grade malignant non-Hodgkin's lymphomas of the mucosa-associated lymphoid tissue (MALT-) type. Cancer Res. 1997; 57 3944-3948
- 33 Auer I A, Gascoyne R D, Connors J M et al.. t(11;18)(q21;q21) is the most common translocation in MALT lymphomas. Ann Oncol. 1997; 8 979-985
- 34 Rosenwald A, Ott G, Stilgenbauer S et al.. Exclusive detection of the t(11;18)(q21;q21) in extranodal marginal zone B cell lymphomas (MZBL) of MALT type in contrast to other MZBL and extranodal large B cell lymphomas. Am J Pathol. 1999; 155 1817-1821
- 35 Ye H, Liu H, Attygalle A et al.. Variable frequencies of t(11;18)(q21;q21) in MALT lymphomas of different sites: significant association with CagA strains of H. pylori in gastric MALT lymphoma. Blood. 2003; 102 1012-1018
- 36 Okabe M, Inagaki H, Ohshima K et al.. API2-MALT1 fusion defines a distinctive clinicopathologic subtype in pulmonary extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue. Am J Pathol. 2003; 162 1113-1122
- 37 Dierlamm J, Baens M, Wlodarska I et al.. The apoptosis inhibitor gene API2 and a novel 18q gene, MLT, are recurrently rearranged in the t(11;18)(q21;q21)p6 associated with mucosa-associated lymphoid tissue lymphomas. Blood. 1999; 93 3601-3609
- 38 Akagi T, Motegi M, Tamura A et al.. A novel gene, MALT1 at 18q21, is involved in t(11;18) (q21;q21) found in low-grade B-cell lymphoma of mucosa-associated lymphoid tissue. Oncogene. 1999; 18 5785-5794
- 39 Lucas P C, Yonezumi M, Inohara N et al.. Bcl10 and MALT1, independent targets of chromosomal translocation in malt lymphoma, cooperate in a novel NF-kappa B signaling pathway. J Biol Chem. 2001; 276 19012-19019
- 40 Inagaki H, Okabe M, Seto M, Nakamura S, Ueda R, Eimoto T. API2-MALT1 fusion transcripts involved in mucosa-associated lymphoid tissue lymphoma: multiplex RT-PCR detection using formalin-fixed paraffin-embedded specimens. Am J Pathol. 2001; 158 699-706
- 41 Liu H, Hamoudi R A, Ye H et al.. t(11;18)(q21;q21) of mucosa-associated lymphoid tissue lymphoma results from illegitimate non-homologous end joining following double strand breaks. Br J Haematol. 2004; 125 318-329
- 42 Sugiyama T, Asaka M, Nakamura T, Nakamura S, Yonezumi S, Seto M. API2-MALT1 chimeric transcript is a predictive marker for the responsiveness of H. pylori eradication treatment in low-grade gastric MALT lymphoma. Gastroenterology. 2001; 120 1884-1885
- 43 Lazarevic V, Cemerikic-Martinovic V, Suvajdzic N, Subotic D, Colovic M. Diffuse primary plasmacytoma of the lung. Haematologia (Budap). 2001; 31 161-165
- 44 Lim J K, Lacy M Q, Kurtin P J, Kyle R A, Gertz M A. Pulmonary marginal zone lymphoma of MALT type as a cause of localised pulmonary amyloidosis. Clin Pathol. 2001; 54 642-646
- 45 Dacic S, Colby T V, Yousem S A. Nodular amyloidoma and primary pulmonary lymphoma with amyloid production: a differential diagnostic problem. Mod Pathol. 2000; 13 934-940
- 46 Fiche M, Caprons F, Berger F et al.. Primary pulmonary non-Hodgkin's lymphomas. Histopathology. 1995; 26 529-537
- 47 Li G, Hansmann M L, Zwingers T, Lennert K. Primary lymphomas of the lung: morphological, immunohistochemical and clinical features. Histopathology. 1990; 16 519-531
- 48 Nicholson A G, Wotherspoon A C, Diss T C et al.. Pulmonary B-cell non-Hodgkin's lymphomas: the value of immunohistochemistry and gene analysis in diagnosis. Histopathology. 1995; 26 395-403
- 49 Cadranel J, Naccache J, Wislez M, Mayaud C. Pulmonary malignancies in the immunocompromised patient. Respiration. 1999; 66 289-309
- 50 Ray P, Antoine M, Mary-Krause M et al.. AIDS-related primary pulmonary lymphoma. Am J Respir Crit Care Med. 1998; 158 1221-1229
- 51 Polish L B, Cohn D L, Ryder J W, Myers A M, O'Brien R F. Pulmonary non-Hodgkin's lymphoma in AIDS. Chest. 1989; 96 1321-1326
- 52 Bazot M, Cadranel J, Benayoun S, Tassart M, Bigot J M, Carette M F. Primary pulmonary AIDS-related lymphoma: radiographic and CT findings. Chest. 1999; 116 1282-1286
- 53 Guinee Jr D, Jaffe E, Kingma D et al.. Pulmonary lymphomatoid granulomatosis: evidence for a proliferation of Epstein-Barr virus infected B-lymphocytes with a prominent T-cell component and vasculitis. Am J Surg Pathol. 1994; 18 753-764
- 54 Bolaman Z, Kadikoylu G, Polatli M, Barutca S, Culhaci N, Senturk T. Migratory nodules in the lung: lymphomatoid granulomatosis. Leuk Lymphoma. 2003; 44 197-200
- 55 Jaffe E S, Wilson W H. Lymphomatoid granulomatosis: pathogenesis, pathology and clinical implications. Cancer Surv. 1997; 30 233-248
- 56 Liebow A A, Carrington C R, Friedman P J. Lymphomatoid granulomatosis. Hum Pathol. 1972; 3 457-558
- 57 Lipford Jr E H, Margolick J B, Longo D L, Fauci A S, Jaffe E S. Angiocentric immunoproliferative lesions: a clinicopathologic spectrum of post-thymic T-cell proliferations. Blood. 1988; 72 1674-1681
- 58 Katzenstein A L, Carrington C B, Liebow A A. Lymphomatoid granulomatosis: a clinicopathologic study of 152 cases. Cancer. 1979; 43 360-373
- 59 Guinee Jr D G, Perkins S L, Travis W D, Holden J A, Tripp S R, Koss M N. Proliferation and cellular phenotype in lymphomatoid granulomatosis: implications of a higher proliferation index in B cells. Am J Surg Pathol. 1998; 22 1093-1100
- 60 Morice W G, Kurtin P J, Myers J L. Expression of cytolytic lymphocyte-associated antigens in pulmonary lymphomatoid granulomatosis. Am J Clin Pathol. 2002; 118 391-398
- 61 Sordillo P P, Epremian B, Koziner B, Lacher M, Lieberman P. Lymphomatoid granulomatosis: an analysis of clinical and immunologic characteristics. Cancer. 1982; 49 2070-2076
- 62 Haque A K, Myers J L, Hudnall S D et al.. Pulmonary lymphomatoid granulomatosis in acquired immunodeficiency syndrome: lesions with Epstein-Barr virus infection. Mod Pathol. 1998; 11 347-356
- 63 Fassas A, Jagannath S, Desikan K R et al.. Lymphomatoid granulomatosis following autologous stem cell transplantation. Bone Marrow Transplant. 1999; 23 79-81
- 64 Sebire N J, Haselden S, Malone M, Davies E G, Ramsay A D. Isolated EBV lymphoproliferative disease in a child with Wiskott-Aldrich syndrome manifesting as cutaneous lymphomatoid granulomatosis and responsive to anti-CD20 immunotherapy. J Clin Pathol. 2003; 56 555-557
- 65 Macon W R, Williams M E, Greer J P et al.. Natural killer-like T-cell lymphomas: aggressive lymphomas of T-large granular lymphocytes. Blood. 1996; 87 1474-1483
- 66 de Bruin P C, Jiwa M, Oudejans J J et al.. Presence of Epstein-Barr virus in extranodal T-cell lymphomas: differences in relation to site. Blood. 1994; 83 1612-1618
- 67 Karakus S, Yalcin S, Guler N, Coplu L, Ayhan A. Angiocentric T-cell lymphoma of the lung mimicking metastatic carcinoma: case report. J Exp Clin Cancer Res. 1998; 17 371-373
- 68 Maejima S, Kitano K, Ichikawa S et al.. T-cell non-Hodgkin's lymphoma of the lung. Intern Med. 1993; 32 403-407
- 69 Beltran Beltran S, de Tomas Labat M E, Ferreras Fernandez P. Primary Ki-1 positive anaplastic large cell non-Hodgkin's lymphoma of the lung. A case study and review of the literature. An Med Interna. 2001; 18 587-590
- 70 Radin A I. Primary pulmonary Hodgkin's disease. Cancer. 1990; 65 550-563
- 71 Chetty R, Slavin J L, O'Leary J J, Ansari N A, Gatter K C. Primary Hodgkin's disease of the lung. Pathology. 1995; 27 111-114
- 72 Catterall J R, McCabe R E, Brooks R G, Remington J S. Open lung biopsy in patients with Hodgkin's disease and pulmonary infiltrates. Am Rev Respir Dis. 1989; 139 1274-1279
- 73 Kiani B, Magro C M, Ross P. Endobronchial presentation of Hodgkin lymphoma: a review of the literature. Ann Thorac Surg. 2003; 76 967-972
- 74 Browne P, Petrosyan K, Hernandez A, Chan J A. The B-cell transcription factors BSAP, Oct-2, and BOB.1 and the pan-B-cell markers CD20, CD22, and CD79a are useful in the differential diagnosis of classic Hodgkin lymphoma. Am J Clin Pathol. 2003; 120 767-777
- 75 Chilosi M, Pizzolo G. Biopathologic features of Hodgkin's disease. Leuk Lymphoma. 1995; 16 385-395
- 76 Stein H, Marafioti T, Foss H D et al.. Down-regulation of BOB.1/OBF.1 and Oct2 in classical Hodgkin disease but not in lymphocyte predominant Hodgkin disease correlates with immunoglobulin transcription. Blood. 2001; 97 496-501
- 77 Costa M B, Siqueira S A, Saldiva P H, Rabe K F, Mauad T. Histologic patterns of lung infiltration of B-cell, T-cell, and Hodgkin lymphomas. Am J Clin Pathol. 2004; 121 718-726
- 78 Kilgore T L, Chasen M H. Endobronchial non-Hodgkin's lymphoma. Chest. 1983; 84 58-61
- 79 Ueda T, Hosoki N, Isobe K et al.. Diffuse pulmonary involvement by mycosis fungoides: high-resolution computed tomography and pathologic findings. J Thorac Imaging. 2002; 17 157-159
- 80 Wolfe J D, Trevor E D, Kjeldsberg C R. Pulmonary manifestations of mycosis fungoides. Cancer. 1980; 46 2648-2653
- 81 Rubin D L, Blank N. Rapid pulmonary dissemination in mycosis fungoides simulating pneumonia: a case report and review of the literature. Cancer. 1985; 56 649-651
- 82 Tanaka N, Matsumoto T, Miura G et al.. CT findings of leukemic pulmonary infiltration with pathologic correlation. Eur Radiol. 2002; 12 166-174 , Epub 2001 Oct 09
- 83 Trisolini R, Lazzari Agli L, Poletti V. Bronchiolocentric pulmonary involvement due to chronic lymphocytic leukemia. Haematologica. 2000; 85 1097
- 84 Gomez-De La Fuente E, Ortiz P L, Vanaclocha F, Rodriguez-Peralto J L, Iglesias L. Aggressive granulomatous mycosis fungoides with clinical pulmonary and thyroid involvement. Br J Dermatol. 2000; 142 1026-1029
- 85 Kitching P A, Gibbs A R. Pulmonary involvement by mycosis fungoides: a case showing angiocentric lesions and granulomas. Pathol Res Pract. 1993; 189 594-596 discussion 597-600
- 86 Filly R, Bland N, Castellino R A. Radiographic distribution of intrathoracic disease in previously untreated patients with Hodgkin's disease and non-Hodgkin's lymphoma. Radiology. 1976; 120 277-281
- 87 Scarpa A, Borgato L, Chilosi M et al.. Evidence of c-myc gene abnormalities in mediastinal large B-cell lymphoma of young adult age. Blood. 1991; 78 780-788
- 88 Menestrina F, Chilosi M, Bonetti F et al.. Mediastinal large-cell lymphoma of B-type, with sclerosis: histopathological and immunohistochemical study of eight cases. Histopathology. 1986; 10 589-600
- 89 Zinzani P L, Martelli M, Bertini M et al.. International Extranodal Lymphoma Study Group (IELSG). Induction chemotherapy strategies for primary mediastinal large B-cell lymphoma with sclerosis: a retrospective multinational study on 426 previously untreated patients. Haematologica. 2002; 87 1258-1264
- 90 Zinzani P L, Tani M, Gabriele A et al.. Extranodal marginal zone B-cell lymphoma of MALT-type of the lung: single-center experience with 12 patients. Leuk Lymphoma. 2003; 44 821-824
- 91 Zinzani P L, Magagnoli M, Ascani S et al.. Nongastrointestinal mucosa-associated lymphoid tissue (MALT) lymphomas: clinical and therapeutic features of 24 localized patients. Ann Oncol. 1997; 8 883-886
- 92 Zucca E, Conconi A, Pedrinis E et al.. International Extranodal Lymphoma Study Group. Nongastric marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue. Blood. 2003; 101 2489-2495
- 93 Wohrer S, Drach J, Hejna M et al.. Treatment of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) with mitoxantrone, chlorambucil and prednisone (MCP). Ann Oncol. 2003; 14 1758-1761
- 94 Raderer M, Isaacson P G. Extranodal lymphoma of MALT-type: perspective at the beginning of the 21st century. Exp Rev Anticancer Ther. 2001; 1 53-64
- 95 Jager G, Neumeister P, Brezinschek R et al.. Treatment of extranodal marginal zone B-cell lymphoma of mucosa associated lymphoid tissue type with cladribine: a phase II study. J Clin Oncol. 2002; 20 3872-3877
- 96 Zinzani P L, Stefoni V, Musuraca G et al.. Fludarabine-containing chemotherapy as frontline treatment of nongastrointestinal mucosa-associated lymphoid tissue lymphoma. Cancer. 2004; 100 2190-2194
- 97 Conconi A, Martinelli G, Thieblemont C et al.. Clinical activity of rituximab in extranodal marginal zone B-cell lymphoma of MALT type. Blood. 2003; 102 2741-2745
- 98 Thieblemont C, de la Fouchardiere A, Coiffier B. Nongastric mucosa-associated lymphoid tissue lymphomas. Clin Lymphoma. 2003; 3 212-224
Marco ChilosiM.D.
Department of Pathology, University of Verona, Policlinico G. B. Rossi, Piazza L.
Scuro, 37134 Verona, Italy
eMail: marco.chilosi@univr.it